Publications

Paracetamol and Serious Skin Reactions

Key Messages

Patients should be advised to seek medical advice immediately if signs or symptoms of serious
skin reactions occur.

Paracetamol should be discontinued in the event of a serious skin reaction.

Paracetamol is widely used to reduce pain and fever and can be
purchased over-the-counter in addition to being prescribed.
Paracetamol is available as a single-ingredient product and in
combination products, including cough and cold preparations.

SCARs include Stevens Johnson Syndrome, toxic epidermal
necrolysis, acute generalised exanthematous pustulosis, and erythema
multiforme. These reactions can occur when using paracetamol for the
first time or at any time during administration, and can be fatal.
It is likely that these reactions occur rarely.

The Centre for Adverse Reactions Monitoring (CARM) has received
four reports of serious skin reactions causally associated with
paracetamol. These included two reports of erythema multiforme, one
of toxic epidermal necrolysis and one of Stevens Johnson Syndrome.

Patients should be advised to consult their doctor at the first
appearance of a skin rash, skin peeling, mouth ulcers, or any sign
of hypersensitivity. If serious skin reactions occur, discontinue
paracetamol immediately.

Non-steroidal anti-inflammatory drugs (NSAIDs) also used to treat
fever and pain/body aches, can also cause SCARs2.
However, there does not appear to be cross-sensitivity between
paracetamol and other medicines that reduce pain and fever1.